Acta Tropica 166 (2017) 249–256 Contents lists available at ScienceDirect Acta Tropica jo ur nal home p age: www.elsevier.com/locate/actatropica Willingness to pay for a dengue vaccine and its associated determinants in Indonesia: A community-based, cross-sectional survey in Aceh Harapan Harapan a,b,c,d,* , Samsul Anwar e , Aslam Bustamam f , Arsil Radiansyah a , Pradiba Angraini a , Riny Fasli a , Salwiyadi Salwiyadi a , Reza Akbar Bastian a , Ade Oktiviyari a , Imaduddin Akmal a , Muhammad Iqbalamin a , Jamalul Adil a , Fenni Henrizal a , Darmayanti Darmayanti a , Mahmuda Mahmuda g , Mudatsir Mudatsir c , Allison Imrie d , R. Tedjo Sasmono h , Ulrich Kuch i , Ziv Shkedy j , Setia Pramana k a Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia b Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia c Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia d School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia e Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Indonesia f Department of Biology, Faculty of Teacher Training and Education, Syiah Kuala University, Banda Aceh, Indonesia g Department of Biology, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Indonesia h Eijkman Institute for Molecular Biology, Jakarta, Indonesia i Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany j Center for Statistics, Hasselt University, Diepenbeek, Belgium k Institute of Statistics, Jakarta, Indonesia a r t i c l e i n f o Article history: Received 19 July 2016 Received in revised form 25 November 2016 Accepted 27 November 2016 Available online 28 November 2016 Keywords: Dengue fever Dengue vaccine Indonesia Vaccine introduction Vaccine demand Willingness to pay a b s t r a c t Vaccination strategies are being considered as a part of dengue prevention programs in endemic coun- tries. To accelerate the introduction of dengue vaccine into the public sector program and private markets, understanding the private economic benefits of a dengue vaccine is therefore essential. The aim of this study was to assess the willingness to pay (WTP) for a dengue vaccine among community members in Indonesia and its associated explanatory variables. A community-based, cross-sectional survey was conducted in nine regencies of Aceh province, Indonesia, from November 2014 to March 2015. A pre- tested validated questionnaire was used to facilitate the interviews. To assess the explanatory variables influencing participants’ WTP for a dengue vaccine, a linear regression analysis was employed. We inter- viewed 677 healthy community members; 476 participants (87.5% of the total) were included in the final analysis. An average individual was willing to pay around US-$ 4 (mean: US-$ 4.04; median: US-$ 3.97) for a dengue vaccine. Our final multivariate model revealed that working as a civil servant, living in the city, and having good knowledge on dengue viruses, a good attitude towards dengue, and good preventive practice against dengue virus infection were associated with a higher WTP (P < 0.05). Our model sug- gests that marketing efforts should be directed to community members who are working in the suburbs especially as farmers. In addition, the results of our study underscore the need for low-cost quality vac- cines, public sector subsidies for vaccinations, and intensifying efforts to further educate and encourage households regarding other dengue preventive measures, using trusted individuals as facilitators. © 2016 Elsevier B.V. All rights reserved. * Corresponding author at: Medical Research Unit, School of Medicine, Syiah Kuala University, Jl. T. Tanoeh Abe, Darussalam, Banda Aceh 23111, Indonesia. E-mail address: harapan@unsyiah.ac.id (H. Harapan). 1. Introduction Dengue, an acute mosquito-borne viral infection, is rapidly spreading in all WHO regions with approximately 390 million new infections annually and 96 million symptomatic cases ranging from mild dengue fever (DF) to dengue hemorrhagic fever (DHF) and http://dx.doi.org/10.1016/j.actatropica.2016.11.035 0001-706X/© 2016 Elsevier B.V. All rights reserved.